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Opening the Conversation on Perinatal Mood Disorders: What Is Postpartum Depression (PPD)?


When a woman is pregnant, she often hears all of the excited and congratulatory feedback (which comes from other's genuine happiness for you and also people's real love of babies). But what a pregnant woman hears less often are any of the very real challenges of going through childbirth and adjusting to life as a 24/7 mom. When everyone's been telling us how blissful having a baby is, the immense emotional and mental shifts that happen postpartum can come as an especially huge surprise.

When I was pregnant with my daughter I had so much anticipatory fear of childbirth that I began to have mild panic attacks whenever I thought of giving birth. I had never suffered from panic attacks before, but I suddenly became plagued by shortness of breath, sweating, and heart palpitations whenever I realized that I actually had to get the growing creature inside of me OUT. One day at a prenatal check up I made a comment to my OB that hinted at my very real struggle. She sat down and asked me more about how I was feeling. As I described my fears tears automatically streamed down my face; I couldn't help it, and I didn't want to help it. She looked at me and said, "oh, when that baby is out and they put the baby on you you'll just be so overwhelmed with love that you'll forget all about what it was like to give birth! Trust me!"

Fast forward to February 20th, 2016 at 11:42pm as my daughter arrived in the world. When they placed her on my chest I didn't feel overwhelmed with love yet. Truth be told, the exact moment the resident pulled her out, I felt horrified. I couldn't believe that baby had just been yanked out of there. I am pretty sure some expletives flew. When I looked at her in those first moments I felt more confused than anything else; not only was I exhausted after days of labor, but I was rather incredulous at the presence of this tiny wrinkled creature I had never before met (who was also as gross looking in that moment as I was). I tried to conjure up all the trasformative and magical things people had told me I was supposed to feel. But instead, I turned to my husband and very seriously said, "I am NEVER doing this again."

The next day my OB stopped in to my room. She wanted to know how it was going. I looked at her and said, "you know how you told me that when you become a mom you forget all about the pain of childbirth? When does that happen? Because every cell in my body hurts and holding this baby is definitely not helping with any of that." I said this half seriously and half in jest. I said it with a laugh, but I wanted her to know that this was no bliss she had described, where warm waves of loving emotions washed over me and replaced all of my anxiety, fears, physical exhaustion and pain (and also caused instant amnesia about all of it). But I was also bothered. Bothered that there were so few people to genuinely hold my experience and hesitations as a real and normal part of the process of becoming a mother. As it turned out, my discharge from the hospital was delayed the next day because my OB had privately told the social worker that I was struggling with Postpartum Depression.

"They won't let me go home because of what!?" I'm pretty sure some more expletives flew. I now encountered an even more unfortunate turn of events. Many women struggle with prenatal and postpartum anxiety, adjustment, and "blues." It's right for our care providers to be vigilant; we don't want any woman to slip through the cracks. But I had simply been asking my doctor for human connection; as in, "hey, can we just tell it like it is? This was incredibly HARD." I remained confused about why we were all pretending it wasn't. My real-ness that day wasn't met with understanding or empathy; it was met with a secret referral to social work.

As I (finally) went home and began my own process of becoming a mom to this new creature who now lived in my home, I reflected on how little insight I was given into what is within the range of normal maternal emotion. As a mental health professional with a training certificate in the treatment of Perinatal Mood Disorders, I was way more equipped than most. But even with this, going through it myself was a completely different story than learning about it from a book or treating it in one of my clients. I also thought of all the women who did not have my training and expertise. What is this experience like for them? Where did they find solidarity? Understanding? Respite?

Through this blog I'd like to shed light on some of the mystery of Postpartum Mood Disorders, starting with Postpartum Depression. I usually don't self disclose to the extent that I have in this post. I chose to do so for the sake of opening up the dialogue and hoping that another woman might see herself in the telling of my own story and feel more validated, less alone. To come full circle on my own postpartum story, I diagnosed myself (only slightly joking but mostly seriously) with postpartum adjustment disorder during that time. As far as I know Postpartum Adjustment Disorder is not a real diagnosis and never has been (I have to pause and chuckle as I realize that its acronym would be PAD, which I had to wear for SO LONG after giving birth that I had to call my doctor again in concern...).

There is nothing humorous about the emotional, mental, and personal challenges that impact women before, during, and after pregnancy. But the more that we can share our stories and be honest and genuine about what's real for us as women and mothers, the more we allow other women to come out of the hiding of their experience and say, "Me too... I thought that was only myself..." With early recognition, women and their partners can begin to seek the resources and support that can be essential in navigating this time of immense and immeasurable change.

What is PostPartum Depression (PPD)?

Statistics state that about 10-20% of women experience postpartum depression. I'd hesitate to think that number is accurate. I'd go so far as to say that the actual percent of women affected is much higher, due to lack of self-report and lack of treatment/diagnosis of PPD for many women.

Symptoms evident in a diagnosis of PPD are listed as follows. Keep in mind that you may be experiencing just some of these symptoms and be struggling with PPD. It does not mean that you can check all of these symptoms off. Consider the extent to which the symptoms that you're experiencing are interfering with your functioning as an individual and as a new mother. Then always check with a licensed mental health clinician who can help you better understand the role of your symptoms as they individually pertain to you.

If you have had a baby in the last year and are feeling some of the following, you may be experiencing PPD:

- You feel completely overwhelmed; you may think you're not sure you can handle being a mother, or you may wonder if you should have become a mother in the first place.

- You feel a sense of hopelessness at the situation, and as you think about the future.

- You aren't bonding to your baby; that blissful mommy feeling is so far out of range you're not really sure what it is (not all women struggling with PPD feel this, but some do).

- You are tearful and crying even when there is no reason to be. At times you are overwhelmed by a deep sadness.

- You feel nothing; you feel devoid of emotion.

- You are confused or scared at what is happening to you.

- You feel guilty. You feel that you should be handling motherhood better than this, or even that your baby deserves better.

- You experience a change in your appetite; desire not to eat, or desire to feel better by eating.

- You are irritated, angry, or short tempered. Everything annoys you and you snap easily.

- You feel in a fog. Thoughts aren't connecting easily. You find it hard to think or focus.

- Your sleep is completely disrupted beyond the disruption of having a newborn.

- You feel disconnected from the people and things you usually feel connected to.

- You feel like a failure.

- You know something is wrong, but aren't sure what it is. You're wondering if maybe you've lost it.

- You've had thoughts, however fleeting, of leaving everything behind and making your escape.

- You're telling yourself to "just snap out of it" and get back to normal, but everything you're doing isn't getting you there and you can't figure out why.

- You're struggling with the loss of the old you and feel that your life has been completely replaced; perhaps you even feel grief at the loss of your old life.

- You worry that if you reach out for help others will judge you, or think you're not fit to be a mom.

- You feel empty or numb. You're just going through the motions.

If you were reading this list and some of what you read felt familiar, it may be beneficial to reach out to your doctor or another trusted care provider. You'll likely want to seek referral to a therapist who is experienced or has specific training in working with postpartum women. I emphasize that a specialty in working with pregnant and parenting mothers is very important in effective treatment of perinatal mood disorders; but I also equally want to emphasize that you should find a provider who upholds your true experience, and who never minimizes or brushes past any of your thoughts, experiences, or feelings.

Its so important to work with a therapist who sees you. Who is committed to getting you better; and who can anchor you in the chaos of what you're struggling with. If you think you may be struggling with a perinatal mood disorder, begin to consider what it would feel like not to struggle with it alone. Does that simple thought give you a vision of solidarity and unburdening? Solidarity and unburdening is just the start... effective treatment can lead you to the brighter life that you've imagined and that you deserve. Don't hesitate. It's too important! Please call me at 860-339-6515 or click here to schedule your initial consultation.

Lauren L. Drago, MSEd, LMHC, LPC is the founder of Lauren Drago Therapy in Old Saybrook, CT and in greater CT, NY & PA. She specializes in working with smart, insightful and capable women to overcome stress, anxiety, loss of identity, self-limiting beliefs, perfectionism, marriage strain, and the pressure of "trying to do it all." Lauren has a passion for helping others to achieve the happy, fulfilling, productive, and meaningful life they deserve by changing how they experience and understand their world. She believes that every woman can and should live out her personal definition of her own best life. Follow Lauren on Facebook, Twitter, and Pinterest. Call (860) 339-6515 for your free initial 15-minute consultation.

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